title: Impact of thulium VapoEnucleation of the prostate on erectile function: a prospective analysis of 72 patients at 12-month follow-up.
abstract: OBJECTIVE
  To evaluate changes in erectile function after thulium VapoEnucleation of the prostate (ThuVEP) for the treatment of benign prostatic obstruction at 12-month follow-up.
  
  
  METHODS
  We prospectively evaluated 72 patients who underwent ThuVEP between January and July 2011. Preoperative evaluation included maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QoL), postvoiding residual urine (PVR), and the Erectile function domain of the International Index of Erectile Function (IIEF-EF). According to preoperative IIEF-EF score, patients were classified into subgroup A (IIEF-EF ≥19, n = 38) and subgroup B (IIEF-EF <19, n = 34). All complications during the perioperative period were noted and classified according to the modified Clavien classification system. All patients were reassessed at 12-month follow-up by Qmax, IPSS, QoL, PVR, and IIEF-EF score. Patient data were expressed as median (interquartile range).
  
  
  RESULTS
  Median patient age was 70 (65-73) years, and the median prostate volume was 52.5 (39.75-72) mL, respectively. At 12-month follow-up, IPSS (20 vs 4), QoL (4 vs 1), Qmax (9.7 vs 22.15 mL/s), and PVR (100 vs 15 mL) improved significantly in comparison with preoperative assessment (P ≤.001) without differences between subgroup A and B. A slight but not statistically significant increase of the IIEF-EF domain score was reported at 12-month follow-up (19.5 vs 20), which could be shown in subgroup A (25 vs 26) and B (6 vs 8).
  
  
  CONCLUSIONS
  ThuVEP is a safe and effective procedure for the treatment of benign prostatic obstruction. At 12-month follow-up, marginal nonsignificant erectile function improvement was reported after surgery.
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany. Electronic address: c.tiburtius@asklepios.com.
authors.forename: Christian
authors.initials: C
authors.lastname: Tiburtius
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
authors.forename: Sophie
authors.initials: S
authors.lastname: Knipper
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Gross
authors.affiliation: Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Netsch
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D011446:Prospective Studies; D013932:Thulium / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate / Q000379:methods*
chemical_list: D013932:Thulium